CMT Pacemaker Monitoring and Function 1 — Questions and Answers
Question 1: In the NASPE/BPEG generic pacemaker code, what does the FIRST letter represent?
- Chamber sensed
- Chamber paced (Correct answer)
- Response to sensing
- Rate modulation
Correct answer: Chamber paced
The first letter in the pacemaker code indicates the chamber being paced (A=atrium, V=ventricle, D=dual).
Question 2: On a rhythm strip, a pacemaker spike is visible but is NOT followed by a P wave or QRS complex. This is called:
- Failure to sense
- Failure to capture (Correct answer)
- Oversensing
- Pacemaker inhibition
Correct answer: Failure to capture
Failure to capture occurs when the pacemaker fires but the electrical stimulus does not successfully depolarize the myocardium.
Question 3: In a VVI pacemaker, what does the second letter 'V' indicate?
- The ventricle is paced
- The ventricle is sensed (Correct answer)
- Both chambers are sensed
- The pacemaker is rate-responsive
Correct answer: The ventricle is sensed
In the VVI code, the second letter indicates the chamber being sensed — in this case, the ventricle.
Question 4: Which pacemaker mode paces the ventricle, senses the ventricle, and INHIBITS pacing output when a native beat is sensed?
- AOO
- AAI
- VOO
- VVI (Correct answer)
Correct answer: VVI
VVI mode paces the ventricle (V), senses the ventricle (V), and inhibits (I) pacing when a native ventricular beat is detected.
Question 5: What is the primary advantage of a DDD pacemaker over a VVI pacemaker?
- It requires less battery power
- It maintains AV synchrony by pacing both chambers (Correct answer)
- It eliminates the need for sensing
- It provides faster pacing rates
Correct answer: It maintains AV synchrony by pacing both chambers
DDD pacemakers maintain AV synchrony by sensing and pacing both atria and ventricles, preserving the atrial contribution to cardiac output.
Question 6: When monitoring a paced rhythm, how does a ventricular paced beat typically appear on ECG?
- Narrow QRS preceded by a P wave
- Narrow QRS preceded by a pacemaker spike
- Wide QRS preceded by a pacemaker spike (Correct answer)
- Normal sinus morphology with a spike after QRS
Correct answer: Wide QRS preceded by a pacemaker spike
Ventricular paced beats produce a wide QRS complex (similar to a bundle branch block pattern) preceded by a pacemaker artifact (spike).
Question 7: What does placing a magnet over a permanent pacemaker typically cause?
- Complete pacemaker inhibition
- Asynchronous pacing at the magnet rate (Correct answer)
- Permanent reprogramming of pacemaker settings
- Immediate deactivation of the pacemaker
Correct answer: Asynchronous pacing at the magnet rate
Applying a magnet converts the pacemaker to an asynchronous (fixed-rate) mode at the manufacturer's designated magnet rate, regardless of intrinsic rhythm.
CMT Pacemaker Monitoring and Function 1
In the NASPE/BPEG generic pacemaker code, what does the FIRST letter represent?